My CT scan (without contrast) states: "Collection of lymph nodes seen within the aortopulmonary window measuring 15 x 17 x 11.5 mm. Apparent slightly progressive increase in size of these mediastinal lymph nodes from last scan (1 yr ago), and new tiny left pulmonary nodule present." Are these measurements describing one lymph node, a group of them, the largest of them, or ??? Should I be concerned. My surgeon says he doesn't know what to make of them. I had double right lobectomy 3 yrs ago and was T4 (multiple tumors in two different lobes), N1, MX (I believe it showed 12 hilar lymph nodes and several interlobular lymph node mets on pathology report, but I have had pretty good scans since that time). Previous scan simply stated "small, stable 8 mm diameter lymph node in superiormediastinum between origin of some of the great vessels from the arch of the aorta", however, on scan before that said "no evidence of hilar or mediastinal lymphadenopathy" , so I don't know how they concluded it was 'stable" (I no longer use the facility which took the previous 2 scans as my surgeon did not hold them in high regard, although they were really really sweet people).
I ready to celebrate 3 yrs of good scans, but am a little concerned. Can you dicipher this for me?
Christine
Reply # - February 26, 2013, 08:15 PM
Reply To: enlarged mediastinum lymph nodes 3 yrs after surgery
Well, a collection of nodes implies that it's a confluent bunch of nodes and not one. It's not possible to say what it represents, but we become more concerned about anything growing over time. On the other hand, if the growth is very slow, that's less worrisome. If the growth has been steady and appreciable that it's clinically significant (e.g., more than 1-2 mm/year, I'd say), then it would be reasonable to consider trying to get an answer by doing a mediastinoscopy. Alternatively, it could be followed further with CT scans, or a PET scan might be done to clarify whether there's any significant hyper metabolism (uptake on the PET scan) that would suggest a process worthy of more directed evaluation sooner vs. later.
Good luck.
-Dr. West